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PHC4 Reports on Hospital Financial Performance

The Pennsylvania Health Care Cost Containment Council (PHC4) has released its annual report on the financial performance of the state’s acute-care hospitals.
Among the highlights (changes in performance are from 2013 to 2014):

The total margin of hospitals state-wide declined 0.36 percentage points, from 6.06 percent to 5.7 percent.
The operating income of acute-care hospitals fell from $1.8 billion to $1.7 billion.
Thirty-four percent of hospitals lose money on operations and 28 percent lost money overall.
Uncompensated care rose 2.2 percent, or $22 million, to $1.07 billion.
The number of hospital discharges and patient days declined.
The number of outpatient visits fell 3.2 percent.
Outpatient services accounted for 44.8 percent of net patient revenue.

To learn more about what PHC4 learned, see its new report Financial Analysis 2014: Volume One: General Acute Care Hospitals.

PA Safety Net Admin2015-05-22T06:00:44+00:00May 22nd, 2015|Uncategorized|Comments Off

Medical Malpractice Suits Fall in PA

Since new laws designed to reduce the number of medical malpractice suits in Pennsylvania were passed in 2003 and 2004, the number of such suits has been cut in half.
Last year, 1463 medical malpractice suits were filed in Pennsylvania. In 2002, 2904 such suits were initiated.
And possibly related, the number of physicians practicing medicine in Pennsylvania has risen – a development that follows a nation-wide trend but is doing so at a rate that exceeds the growth in the number of doctors in other states.
To learn more about what Pennsylvania did to reduce medical malpractice lawsuits, how those laws are working, and how this may or may not be affecting the state’s supply of practicing physicians, see this Pittsburgh Post-Gazette article.

PA Safety Net Admin2015-05-21T06:00:46+00:00May 21st, 2015|Uncategorized|Comments Off

5% of Medicaid Recipients Account for 50% of Costs

Just five percent of all Medicaid recipients are responsible for nearly half of the program’s expenditures.
Or so says a new report by the U.S. Government Accountability Office (GAO).
Conversely, the 50 percent of Medicaid’s least costly recipients account for only eight percent of the program’s costs.
Disabled Medicaid recipients, while fewer than 10 percent of the overall total, represent nearly two-thirds of the highest-cost group.
These figures reflect spending from 2009 through 2011.
The greatest Medicaid expenditures were invested in seven types of care: for patients with asthma, diabetes, HIV/AIDS, mental health conditions, substance abuse, and delivery or childbirth along with those residing in long-term-care facilities.
To learn more about the GAO’s findings, see a summary of the report Medicaid: A Small Share of Enrollees Consistently Accounted for a Large Share of Expenditures and find a link to the complete report here on the GAO web site.

PA Safety Net Admin2015-05-14T06:00:46+00:00May 14th, 2015|Uncategorized|Comments Off

Chairmen Seek Ideas for Improving Medicaid

The chairmen of four key congressional committees have written to the Medicaid and CHIP Payment and Access Commission (MACPAC) seeking “assistance in developing policy options to ensure the sustainability of the Medicaid program so it can continue to provide essential coverage and services to vulnerable populations.”
The letter, signed by the chairmen of the Senate Finance Committee, Senate Committee on Health, Education, Labor, and Pensions, the House Energy and Commerce Committee, and the Energy and Commerce Committee’s Health Subcommittee, asks MACPAC to “analyze and evaluate” financing reforms to reduce government spending; past reform proposals; ways to give states greater flexibility; options for Medicaid block grants; and other potential changes.
See the letter here.

PA Safety Net Admin2015-05-06T06:00:17+00:00May 6th, 2015|Uncategorized|Comments Off

PA Needs More Primary Care Docs

Pennsylvania will need 11 percent more primary care doctors by 2030, according to the Joint State Government Commission.
The state already has 155 health professional shortage areas for primary care, and with 27 percent of Pennsylvania’s doctors 60 years of age or older and more than half older than 50, the commission believes the state needs to take steps to ensure the adequacy of its future supply of physicians.
With this need in mind, the commission has offered a series of recommendations for increasing Pennsylvania’s supply of doctors, including encouraging medical schools to do more to train primary care providers, improving student loan repayment programs, and offering more residency positions in the hope that more residents will remain in the state.
For a closer look at the commission’s findings and recommendations, go here for a Central Penn Business Journal article and here for the commission’s report itself.

PA Safety Net Admin2015-04-24T06:00:54+00:00April 24th, 2015|Uncategorized|Comments Off

Looking at Payment and Delivery System Reform

Last fall the Robert Wood Johnson Foundation brought together grant recipients and national experts to talk about health care payment and delivery system reform design and implementation issues.
Now, the foundation has released a brief paper that addresses what the experts consider to be the three greatest challenges in the pursuit of such reform:

Aligning alternative payments with clinician compensation
Considering social determinants of health in payment reform models
Repurposing hospital resources

The paper also takes a look at whether health care payments should be subject to risk adjustment to reflect the social and economic barriers to better health and care that some patients face. This is an important issue for Pennsylvania’s safety-net hospitals because of the significant numbers of low-income patients they serve.
These issues and more are addressed in greater detail in the new paper “Three Emerging Challenges for Sustained Payment and Delivery System Reform,” which can be found here.

PA Safety Net Admin2015-04-14T06:00:13+00:00April 14th, 2015|Uncategorized|Comments Off

Medicare-Medicaid Coordination Office Reports to Congress

The federal agency created by the Affordable Care Act to facilitate better coordination of federal benefits for those eligible for both Medicare and Medicaid has issued its annual report on its activities to Congress along with a number of recommendations for future policy changes.
In addition to reporting on its work over the past year, the Medicare-Medicaid Coordination Office recommended that Congress consider legislation to:

Create a pilot to expand the PACE program (Programs of All-Inclusive Care for the Elderly) to people between the ages of 21 and 55.
Ensure retroactive Medicare Part D coverage for newly eligible low-income beneficiaries.
Establish an integrated appeals process for dually eligible (Medicare and Medicaid) enrollees.
Allow for federal/state coordinated review of duals special need plan marketing materials.

The report also identified three areas the agency intends to explore further in the coming year:

Coverage standards for overlapping Medicare and Medicaid benefits.
Cost-sharing rules for qualified Medicare beneficiaries.
Quality measures and Medicare-Medicaid enrollees.

Because they serve so many low-income, dually eligible patients, Pennsylvania’s safety-net hospitals often have a considerable stake in this office’s efforts.
Find the Medicare-Medicaid Coordination Office’s complete report to Congress here.

PA Safety Net Admin2015-04-10T06:00:12+00:00April 10th, 2015|Uncategorized|Comments Off

MACPAC Looks at DSRIP

The legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and state governments on Medicaid and Children’s Health Insurance Program (CHIP) issues recently took a look at a relatively new type of supplemental Medicaid funding.
The Medicaid and CHIP Payment and Access Commission (MACPAC) is examining Delivery System Reform Incentive Payment Programs (DSRIP), which it describes as

a new type of supplemental payment that provide incentive payments for hospitals and other providers to undertake delivery system transformation efforts. Currently operating in California, Texas, Massachusetts, Kansas, New Jersey, and New York, DSRIP projects are led by hospitals, but often involve collaborations with non-hospital providers. They generally fall into two categories—infrastructure development and care innovation and redesign. Payments are tied to corresponding improvements in health outcomes for Medicaid enrollees and the uninsured.

MACPAC’s staff delivered a presentation on DSRIP to commission members. See that presentation here.

PA Safety Net Admin2015-04-08T06:00:53+00:00April 8th, 2015|Uncategorized|Comments Off

GAO Reports on CHIP Extension

As a House-approved bill that would extend authorization for the Children’s Health Insurance Program (CHIP) for two years awaits Senate consideration, the U.S. Government Accountability Office (GAO) has issued a mandated evaluation of the program.
Among the GAO’s findings, it concluded that children enrolled in the program

… (1) had substantially better access to care, service use, and preventive care when compared with uninsured children; and (2) experienced comparable access and service use when compared with privately insured children.

It also found that nearly all children between the age of one and two enrolled in CHIP or Medicaid made at least one visit to a primary care physician in 2013; that the program’s costs for families were almost always less than states’ benchmark plans established under the Affordable Care Act; and that its benefits were generally comparable to those offered by benchmark plans.
For a closer look at the GAO report Children’s Health Insurance Program: Effects on Coverage and Access, and Considerations for Extending Fund, find links to a summary and the full report here, on the GAO web site.

PA Safety Net Admin2015-04-02T06:00:52+00:00April 2nd, 2015|Uncategorized|Comments Off

State Uses DSRIP Innovation Funding to Improve Care for Urban Poor

New York Medicaid program is taking advantage of federal innovation money to explore new approaches to serving low-income urban Medicaid patients.
With the help of Delivery System Reform Incentive Payments (DSRIP), special Medicaid funding from the federal government, caregivers serving Medicaid patients are organizing into accountable care organizations (ACOs) in New York City.
Under the experiment, doctors and hospitals join together to serve populations of Medicaid patients. While the doctors are currently paid on a fee-for-service basis, the program’s goal is to move them toward outcomes-based reimbursement, with bonuses paid to providers who achieve specific goals for improving the health of their patients.
The state plans to spend $1 billion over the next five years on this aspect of its innovation program.
Learn more about how New York seeks to use DSRIP funding to improve the delivery of care to its Medicaid population in this New York Times report.

PA Safety Net Admin2015-04-01T12:00:51+00:00April 1st, 2015|Uncategorized|Comments Off

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